Publications by authors named "Tounian P"

Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated allergy without known biomarkers. We aimed to compare fecal biomarkers related to gut inflammation and immunity in children with FPIES, with resolved FPIES (tolerant), and in matched controls.

Methods: Stools were collected from FPIES children on elimination diet, before and after an oral food challenge (OFC) performed to assess their natural tolerance, at the end of a follow-up in tolerant FPIES children, and in matched controls (1:1 ratio).

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Background And Objective: In 2022, recommendations for vitamin D supplementation in children were updated in France. The objective of this study was to assess real-life practices of vitamin D supplementation in children following these recommendations.

Methods: A thirty-three-question questionnaire was distributed to members of the scientific societies of paediatrics and general medicine via an online platform.

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A large proportion of prescriptions for extensively hydrolyzed cow's milk protein (CMP) in newborns are not based on any scientific data justifying the indication. Many of these prescriptions are old habits or are based on incomplete data. The aim of this article is to analyze these practices and propose recommendations.

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Background: Heterozygous familial hypercholesterolemia (HeFH) predisposes to premature cardiovascular diseases. Since 2015, the European Atherosclerosis Society has advocated initiation of statins at 8-10 years of age and a low-density lipoprotein cholesterol (LDL-C) target of <135 mg/dL. Longitudinal data from large databases on pharmacological management of pediatric HeFH are lacking.

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Background: The determinants of early-onset obesity (< 6 years) are not completely elucidated, however eating behavior has a central role. To date no study has explored eating behavior in children with severe, early-onset obesity. Self-administered questionnaire data from these children were examined to evaluate eating behavior and the etiology of early-onset obesity.

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Purpose: Infant regurgitation is associated with other functional gastrointestinal disorders and signs and symptoms that have a major impact on the quality of life of infants and their families. This study evaluated the safety, tolerance, and real-world effectiveness of an anti-regurgitation formula containing locust bean gum (LBG), prebiotics, and postbiotics to alleviate digestive symptoms beyond regurgitation.

Methods: This 3-month study involved infants with regurgitation requiring the prescription of an anti-regurgitation formula according to usual clinical practice.

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Article Synopsis
  • Approximately 100 obese adolescents in France undergo bariatric procedures annually, with this study focusing on those who had Roux-en-Y gastric bypass (RYGB) since previous data primarily covered other procedures like LAGB and SG.
  • The study analyzed 26 adolescents aged 13-19 who underwent RYGB, observing a significant BMI decrease from a mean of 52.0 kg/m² to 35.7 kg/m² after two years, along with improvements in several comorbidities.
  • Adverse events were generally low, with few complications noted, and the outcomes were comparable to those seen in adult patients undergoing the same procedure.
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Background: Little is known about blood lymphocyte subpopulations in children with common (CO) or syndromic (SO) obesity. We aimed to describe the blood lymphocyte profiles of obese children and to search for associations with clinical phenotypes.

Methods: Main blood lymphocyte subpopulations were analyzed in 159 children with CO and 34 with SO in a retrospective cohort.

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The first objective of infant formulas is to ensure the healthy growth of neonates and infants, as the sole complete food source during the first months of life when a child cannot be breastfed. Beyond this nutritional aspect, infant nutrition companies also try to mimic breast milk in its unique immuno-modulating properties. Numerous studies have demonstrated that the intestinal microbiota under the influence of diet shapes the maturation of the immune system and influences the risk of atopic diseases in infants.

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Obepi-Roche 2020 by the "Ligue Contre l'Obésité" (League Against Obesity) estimated overweight and obesity prevalence in France. The adopted methodology was chosen to be as similar as possible to that of a series of quota-based surveys conducted every three years from 1997 to 2012 (Obepi-Roche studies). The 2020 survey was conducted online from 24th September to 5th October 2020 by the Odoxa polling institute on a sample of metropolitan French subjects aged 18 years or over.

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Article Synopsis
  • - The study aimed to evaluate the prevalence and causes of renal and urinary manifestations (RUM) in pediatric patients with inflammatory bowel disease (IBD) and to examine any potential link to the treatment using 5-aminosalicylic acid (5-ASA).
  • - Among 228 children with IBD, 9 (3.9%) experienced RUM, primarily in those with Crohn's disease; most were on 5-ASA, but only one had renal issues directly linked to the medication.
  • - The findings showed a general decline in kidney function over time, with 19% of patients eventually having impaired renal function, highlighting the need for regular monitoring of kidney health in children with IBD.
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Background: Clinician's choice of hypoallergenic formulas in the first-line management of cow's milk protein allergy (CMPA) should be informed by evidence on clinical efficacy and cost-effectiveness.

Objective: We compare the cost-effectiveness of amino acid-based formula (AAF), extensively hydrolyzed casein formula with Lactobacillus rhamnosus Gorbach Goldin (EHCF+LGG), extensively hydrolyzed whey formula (EHWF), and rice hydrolyzed formula (RHF) in non-breastfed children in France.

Methods: Immunotolerance and atopic manifestations' prevalence were based on a prospective non-randomized study with a 36-month follow-up.

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Objective: To identify childhood and parental factors associated with initiation of statin therapy in children with heterozygous familial hypercholesterolemia (HeFH), including underlying genetic diagnosis or parental premature atherosclerotic cardiovascular disease (ASCVD).

Study Design: This multicenter cohort study included 245 HeFH child-parent pairs from the REFERCHOL national register (2014-2020). Demographic and clinical characteristics at the last visit were collected.

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Article Synopsis
  • The study aims to provide guidance on calcium and vitamin D supplementation in newborns, infants, children, and adolescents to prevent deficiencies like rickets.
  • The research utilized a PICO framework to form clinical questions, focusing on children aged 0-18 and hospitalized premature babies, with input from various pediatrics experts.
  • The document outlines 35 clinical practice points for the use of vitamin D and dietary calcium, with plans for periodic revisions and suggestions for future research on vitamin D in children.*
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Background: Food protein-induced enterocolitis syndrome (FPIES) is a non-IgE-mediated food allergy, with potential dehydration secondary to vomiting. Differences exist regarding culprit foods, and age of tolerance depending on the country of origin. We aimed at describing the characteristics of a French population of children with FPIES, and define risk factors for failure during challenge.

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Adequate dietary intake for infant development. The main nutrients required for an adequate infant de¬velopment, particularly neurological, are some lipids (essential fatty acids, arachidonic and docosahexaenoic acids), iron, calcium and vitamind. Appropriate energy intake is also necessary to allow growth.

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Aim: To assess the impact of complementary feeding bottles given at maternity hospital and/or over the first month after discharge from the maternity ward on cow's milk allergy (CMA) risk in breastfed infants.

Methods: Case-control study involving infants aged 6-9 months and who were breastfed for at least 1 month.

Results: In 554 cases with a diagnosis of CMA and 211 controls, feeding bottles at maternity hospital, feeding bottles during the first month of life, avoidance of dairy products during pregnancy or breastfeeding, family history of allergy, intake of antibiotics and consumption of proton-pump inhibitors or antacids by the infant during the first month of life were associated with increased risk of CMA in a univariate model.

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Mental health after bariatric surgery during adolescence has been little explored. This is a sensitive period in terms of self-image on which bariatric surgery could have negative effects because of the rapid and significant changes in morphology it induces. Previous studies have explored mental effects using questionnaires and only related to psychopathological disorders.

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Article Synopsis
  • Severe childhood obesity negatively impacts left atrial (LA) function, evidenced by decreased reservoir and contractile functions compared to non-obese peers.
  • The study utilized advanced MRI techniques to measure cardiac strain in 45 children aged 7-18, focusing on those with severe obesity defined by a high body mass index.
  • Findings highlighted reduced LA and right ventricular (RV) performance and increased left ventricular (LV) mass, suggesting significant cardiovascular consequences of severe obesity in children.
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  • The study investigates the role of heterozygous variants in genes related to severe obesity, specifically focusing on LEP, LEPR, POMC, and PCSK1.
  • It analyzed data from 1486 individuals with severe obesity, finding a higher frequency of heterozygous variants compared to homozygous ones, and noted differences in BMI and obesity onset between these groups.
  • The findings suggest that heterozygous variants can lead to significant obesity-related phenotypes and highlight the need for targeted genetic analysis in cases of severe early-onset obesity for potential therapeutic strategies.
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